We are very sorry for your loss, and we appreciate that this is an extremely difficult time for you.
This questionnaire is for parents who have experienced the loss of their baby/babies during pregnancy or shortly after birth. Please complete as much or as little of the form that you are able to. Some questions may not be relevant to your experience. Your feedback will help us to improve bereavement services in maternity across Leeds.
Please tick the relevant box for each question (the survey will take around 10 minutes to complete) and write any comments you might have. All information given will remain anonymous unless you wish to provide your contact details at the end of this questionnaire.
If you would like to discuss any aspects of your care, please contact:
Specialist Bereavement Midwife
Haamla Office, Antenatal Clinic, Level 4, Gledhow Wing,
St James's University Hospital, Beckett Street, Leeds, LS9 7TF